Kyla Crispe, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

2800 E Broad St
Ste #124
Mansfield, TX 76063-6414

Phone

(817) 539-0959

NPI assigned

Aug 28, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

University of North Texas HSC, College of Osteopathic Med, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as individual

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oliver Street 5.01(a) Inc.

  dba U.S. Dermatology Partners

  • Dermatology Physician
  • Dallas, TX
  • NPI 1457695413
  Medicare reassignment Care Compare group
• Mansfield Dermatology, PLLC

  • Dermatology Physician
  • Mansfield, TX
  • NPI 1598913253
  Medicare reassignment
• United Dermatology Associates of Burleson, PLLC

  dba Jeannine Hoang, MD

  • Dermatology Physician
  • Burleson, TX
  • NPI 1457778474
  Medicare reassignment
• United Dermatology Associates of Flower Mound, PLLC

  • Dermatology Physician
  • Flower Mound, TX
  • NPI 1649602954
  Medicare reassignment
• Dermatology Associates

  • Dermatology Physician
  • Houston, TX
  • NPI 1356523039
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472342400000",
    "number": "1740736099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST",
            "address_2": "STE #124",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636414",
            "telephone_number": "817-539-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E BROAD ST",
            "address_2": "STE #124",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760636414",
            "telephone_number": "817-539-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISPE",
        "first_name": "KYLA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Couture, MS, LPC
• Aquarius Cox, LPC
• Heather Cox, M.S., CCC-SLP
• CPR Connection LLC
• Sonya Crawford
• Charlaine Ann Crocker, RNFA
• Melissa Dawn Crocker, CPNP
• Monica Elease Crosby, LMSW
• Crosspointe Dental and Orthodontics, Inc
• Jason Don Crowley, M.D., M.P.H.

• Medical Physician Assistant in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.